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PHILADELPHIA — The West Nile virus has spread faster and farther than in years past, federal health officials said Thursday, confirming predictions made since the virus was first discovered in the United States in 1999.

In the first major report on the virus this year, researchers at the Centers for Disease Control and Prevention and other agencies said there is nothing to prevent the mosquito-borne virus from spreading nationwide.

But they also said there is nothing to be alarmed about. The virus does not pose the threat of a massive epidemic, said the scientists, who encouraged an expansion in mosquito control programs and common sense prevention techniques.

“Yes, I’m concerned that the virus is here … but I’m not frightened,” said Stephen Ostroff, an epidemiologist with the CDC in Atlanta, one of the places where infected birds have been found. “I hope that’s the way the public accepts information about West Nile.”

Ostroff pointed to the West Nile outbreak last year in Israel, where dozens of people died, as evidence that the virus can pose a more serious threat if communities don’t prepare.

The CDC encourages people to use insect repellent and wear long sleeves outdoors. Pools of standing water, where mosquitoes often breed, should be removed.

“All risks are obviously relative,” said Barbara Reynolds, a CDC spokeswoman. “When you’re dealing with an emerging infectious disease there’s going to be a certain amount of notoriety to it until people get used to it.”

Last year, 21 human West Nile cases were reported. Two were fatal.

So far this year, the only confirmed human case is a 73-year-old Florida man, who is still hospitalized with encephalitis.

Infected birds have been found in nine states plus the District of Columbia, and far earlier in the season than they were discovered in 2000. Sample pools of mosquitoes have tested positive for the virus in four states.

Only the very old, very young and those with weak immune systems risk serious illness from the virus, which is spread by mosquitoes and causes flu-like symptoms. Usually it causes such a mild infection in humans that it goes unnoticed.

In fact, a new study in The Lancet suggests that in the summer of 1999 — the first known outbreak of West Nile in North America — for every New Yorker diagnosed with encephalitis or meningitis from West Nile virus, there were probably 140 milder infections that went undetected.

The findings, which suggest that 2.6 percent of the metropolitan New York City population was infected during that outbreak, indicate that West Nile infections are vastly underreported.

The researchers, from the New York City Department of Health and the CDC, estimated that in the 1999 outbreak — when 59 people were hospitalized and seven of them died — about 8,200 people probably were infected, and that 1,700 of those came down with West Nile fever.

As the mosquito season on the U.S. East Coast intensifies and the virus threatens to spread elsewhere, health officials writing in the British medical journal say that doctors should consider West Nile infection when diagnosing unexplained summertime fever, especially if it’s accompanied by headaches, muscle ache and joint pain.

As with most viruses, once people are infected with West Nile virus, they are immune to it for the rest of their lives.

Copyright © 2001 The Philadelphia Inquirer. Distributed by Knight Ridder /Tribune Information Services. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

CDC urges more mosquito-control efforts to stop spread of West Nile virus

By ERIN McCLAM Associated Press Writer

ATLANTA (AP) — Federal officials warned health agencies Thursday to step up mosquito-control efforts and other measures to stop the spread of the dangerous West Nile virus, which is turning up around the Southeast.

The virus, which has killed nine people in New York and New Jersey since 1999, appeared this month in a Florida man, and in dead birds in Florida, Georgia and Virginia. Mosquitos can carry the virus from birds to humans and other animals.

The disease has been confined mostly to the Northeast and mid-Atlantic states.

“Most of us believe it’s only a matter of time before we see additional findings between Florida and where it’s already been reported,” said Dr. Stephen Ostroff, an epidemiologist with the Centers for Disease Control and Prevention.

The CDC urged Americans to clean out standing water from clogged gutters, stagnant bird ponds, overturned trash can lids and anywhere else mosquitos can gather and lay eggs.

“The best advice I have is not to get the mosquito bite in the first place,” Ostroff said.

The CDC left to state and local governments the decision of whether to spray for mosquitos. In Madison County, Fla., where a 73-year-old man contracted West Nile, agriculture officials plan to spray.

Around the South, mosquitos are being trapped and hundreds of dead birds collected as health officials test for the virus.

“We

on the webCDC West Nile page
can’t put up a mosquito net at the state borders,” said Dr. Don Williamson, state health officer for Alabama. “We will have West Nile.”

West Nile virus appears first as a flulike illness. But for patients most at risk — primarily the elderly and people with weak immune systems — it can cause deadly encephalitis, or inflammation of the brain.

The government warned there is nothing to prevent the virus from spreading into the Midwest or farther, depending on the migratory patterns of birds that carry West Nile, particularly crows.

Copyright 2001 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

The Associated Press

LONDON (AP) — For every New Yorker diagnosed with encephalitis or meningitis from West Nile virus in the summer of 1999, there were probably 140 milder infections that went undetected, scientists have estimated.

The findings, which suggest that 2.6 percent of the metropolitan New York City population was infected during that outbreak, indicate that West Nile infections are vastly underreported.

As the mosquito season on the U.S. East Coast intensifies and the virus threatens to spread elsewhere, health officials advised in The Lancet medical journal that doctors should consider West Nile infection when diagnosing unexplained summertime fever, especially if it’s accompanied by headaches, muscle ache and joint pain.

For most people, West Nile virus causes only a flu-like sickness and many who are exposed don’t get sick at all. It is mostly a concern for the elderly. Recent research has found that people with diabetes or those 75 or older were more than five times more likely to die than others.

In 1999, the first year the virus was found in the Western Hemisphere, 59 people were hospitalized with encephalitis or meningitis and seven of them died. Last year, 21 human West Nile cases were reported, two of them fatal, according to the U.S. Centers for Disease Control and Prevention.

The researchers, from the New York City Department of Health and the disease control centers, estimated that in the 1999 outbreak, about 8,200 people probably were infected, and that 1,700 of those came down with West Nile fever.

“From now on we’re not only going to be focusing on the tip of the iceberg,” said the study’s leader, Dr. Farzad Mostashari, a medical epidemiologist at the New York City Department of Health.

“We also recognize that for every case of encephalitis or meningitis, there are likely to be 140 infections and maybe 30 individuals with mild illness.”

As with most viruses, once a person is infected with West Nile virus, they are immune to it for the rest of their lives.

West Nile virus was first reported in Uganda in 1937. Cases have been reported since in Europe, the Middle East, West and Central Asia, and the Pacific Islands, as well as Africa and North America.

On Monday, a 73-year-old man tested positive for West Nile virus in Florida after being bitten by a mosquito last week. If the diagnosis is confirmed by the CDC, it would be the first human West Nile case in Florida.

Copyright 2001 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.

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